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Theme: buildings for health

1 October, 2003

Theme: buildings for health

Keen to avoid an institutional appearance, architects are rising to the challenge of creating health-related projects with a colourful and cheerful ambience while simultaneously catering for the tough everyday demands placed upon them Architects designing for health and disability have an almost obsessive desire to avoid creating buildings that look and feel institutional.

For Peter Liddell, an associate with Penoyre & Prasad Architects, this means eschewing 'the standard healthcare kits' and specifying instead bespoke flooring, wall coverings and doors. 'We try not to use plastic door guards, bumpers and corner profiles, ' he says, 'and to bring more wood into our interiors - as wood's warmer and easier to maintain [than plastics].' For sanitaryware, Penoyre & Prasad usually specifies Twyford or Armitage Shanks and specialist suppliers such as Arjo and Pressalit, whose products are 'much more cheerful than other ranges'.

It is difficult, concurs Magali Marcouire of Feilden Clegg Bradley Architects, to find healthcare solutions that are not 'roundcornered and melamine-faced'. It is also extremely hard, she adds, to find products that cater for mental-health needs, such as 'decent' anti-barricade ironmongery and curtain rails that support curtains but not the weight of a person. 'We have worked with the architectural ironmonger AICS to provide anti-ligature door closers, antibarricade door furniture and pull handles, ' she explains, but insists that there is still a long way to go.

Feilden Clegg Bradley has recently completed a £780,000 refurbishment project at Springfield Hospital in south London. This included combining two existing wards in the listed Victorian building to provide a new ward for patients suffering from eating disorders.

It has also completed several other health-related projects, including a homeopathic clinic in Bristol, nursing homes in Bath and Bristol, and the Broadway Centre in Shepherds Bush, West London.

Designed for the Peabody Trust, this latter project provides a range of care facilities for the single homeless with alcohol-related problems. The scheme was developed in close consultation with the agencies caring for the client group, explains Feilden Clegg Bradley's Stephanie Laslett, and the design process included presentations to planning officers, local residents and potential users.

The incorporation of visually bright surfaces and lots of natural light, 'to keep spirits up', was among the client group's key considerations, says Laslett, as was security. To prevent thresholds feeling like fortresses, the architect took a passive approach to security, she says, with lots of glazing, perforated brick walls and a tactile, cedar front door bringing 'a sort of softness' to the scheme.

Floors, which are solid beech from Junckers and incorporate underfloor heating, and walls covered in hardwearing but 'non-institutional looking' Valtti Luja paint, were specified for their robustness and ease of cleaning. So too were the doors, with their 'chunky' architraves and stainless steel ironmongery.

While materials and details on healthcare projects have to be hardwearing and safe, remarks Magali Marcouire, she says that she now recognises a genuine desire in the NHS to provide non-institutional environments.

However, she explains that in one area, namely wall coverings, the NHS is tending towards sheet materials, rather than tiles, in kitchens and wash areas, 'in a bid to avoid difficult-to-clean-joints'. For this reason, Marcouire says, she still finds herself specifying PVC-based products such as Caterclad or Altro Whiterock, 'which are not ideal, and also look very institutional'.

Taking this one step further, the initial brief for a 60-bed long-term high dependency unit for the elderly near Cork, in the Republic of Ireland (AJ 10.7.03), insisted that it 'should feel more like a retreat or a resort hotel', explains Building Design Partnership (BDP) project director Benedict Zucchi. St Joseph's Hospital, which also includes sheltered housing in the form of an intermediate care unit, is part of a larger masterplan by BDP to create a healthcare village for the Bon Secours Sisters, with distinct residential clusters, each with about 10 rooms and its own communal lounge and support facilities.

Timber finishes give communal spaces a common identity, explains Zucchi, 'and freer forms mark them out from the more domestic clusters'. This distinction is reinforced, he adds, by the roof materials: clay pantiles for the clusters and standing-seam zinc for the communal spaces.

The term 'institutional' could certainly never be applied to Dundee's newly completed Maggie's Centre - Frank Gehry's first building in the UK. This geometrically complex, aluminium-clad structure, while unmistakably the work of Gehry, is just one-hundredth the size of the Bilbao Guggenheim.

As Douglas Reid, on-site partner for executive architect James F Stephen Architects, points out, this is not a medical facility, but a drop-in day centre; a space which, just as the late Maggie Keswick Jencks intended, will make people feel better rather than worse.

Again, products and finishes are bespoke, from free-standing furniture to the hardwood floor, from sliding glass screens to stairs in which no two treads or risers are the same shape. The only standard items are the 'white goods', says Reid, but even the hob is housed in a specially designed elliptical island.

James F Stephen Architects has also completed a number of healthcare-related projects for its local Dundee NHS Trust. These include a child and family psychiatric facility, which, like the nearby Maggie's Centre, relies on the use of natural materials and the fact that it has been built 'at a human scale', to prevent it looking too clinical. 'This and the use of lots of colour, ' Reid adds.

Colour is also an important factor in the healthcare buildings of Penoyre & Prasad, says Peter Liddell. 'We try and use colour on walls and floors to cut down on signing.'

He explains that a wide and varied colour palette is one reason why he repeatedly specifies linoleum and rubber-based flooring materials for healthcare buildings - that and the fact that, unlike PVC products, both are natural and sustainably sourced. 'Lino sits well in healthcare and other public access buildings, ' he says, 'it's cleanable, wears well, and is a natural product.'

BDP is currently working on the Great Western District General Hospital in Swindon, a 55,000m 2PFI replacement for the town's Princess Margaret Hospital. Interior designer Lee Cheong has specified both linoleum floors (from Forbo-Nairn) and Mondo rubber floors from Altro.

'We appreciate the importance of materials that are robust, easy to maintain and do not carry risk of infection, ' he explains.

'Where possible we prefer natural and recyclable materials, in line with our policy of embracing sustainability, and floor finishes such as linoleum and rubber also give us enormous opportunities for incorporating art and design.'

For architects insistent that PFI stifles innovative design, Nightingale Associates' newly completed six-storey Golden Jubilee Wing at King's College Hospital in London may come as a pleasant surprise.

The building's curved facade comprises 2,000m 2of MC Trame Horizontale curtain walling from Technal and is arguably, in itself, a vast piece of artwork, albeit one that is both huge and functional.

The £76 million PFI scheme provides a wide range of facilities, including a new maternity unit, medical wards and a large ambulatory-care centre. 'The curtain walling is facetted to produce a gentle curve - a much more cost-effective solution than curved glass, ' explains Nightingale Associates' director David Cannon. Arrowhead fins and concealed windows help ventilate the building naturally, he adds, and an opaque square pattern etched on to the glazed spandrel panels conceals services between floors.

'We specified this particular product because we knew what we wanted in terms of performance and aesthetics, ' says Cannon, of the Technal curtain walling. 'We try to specify generically where we can, ' he adds, 'but sometimes have to point to a product to assure quality.'

For door furniture, Cannon says that he can always rely on Allgood and Hewi for good quality products. Things are more difficult, he says, when it comes to specifying products to comply with changing regulations. 'For example, with the requirement that grab rails be incorporated into wall protection, ' he says, 'we've found that standard products do not conform with the latest legislation and we are now having to develop our own.'

Given the huge number of constraints associated with building for health and disability, not least the far-reaching requirements of the third stage of the Disability Discrimination Act (which comes into force this month), it is reassuring to learn that aesthetics remain a primary concern for many specifiers. After all, visual appeal goes a long way, not only in instilling confidence inpatients and visitors, but also in providing a pleasant working environment for staff.

'I would never specify something that was ugly even if it were practical, ' says Guy

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